Effect of mood on long-term disability in younger stroke survivors: results from the Psychosocial Outcomes In StrokE (POISE) study

Abstract

ABSTRACT Background & Purpose Anxiety and depression are common among stroke survivors, and their effect on long-term outcome remains unknown in those under 65 years of age. We investigated the association between early anxiety/depression after stroke and 12-month disability, and whether this is modified by sex. Methods The Psychosocial Outcomes In StrokE (POISE) study was a prospective observational cohort study that recruited 441 younger (< 65 years) stroke survivors ≤28 days of acute stroke. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and disability using the World Health Organization Disability Assessment Scale version II (WHODAS-II). Associations between baseline anxiety/depression, and disability at 12-months was tested using analysis of covariance. Subgroup analysis was conducted using interaction term. Results 92 (25%) had anxiety and 53 (14%) depression at baseline. Multivariable models showed significant association between baseline anxiety and 12-month disability (WHODAS-II score 15.24 vs. 11.49, p < .05). Those with anxiety had more impairment in ‘cognition’ (WHODAS-II score 18.26 vs. 8.71, p < .001), ‘getting along’ (WHODAS-II score 11.87 vs. 7.42, p < .05) and ‘participation’ (WHODAS-II score 22.37 vs. 15.92, p < .005) WHODAS-II. No significant relationship was found between baseline depression and long-term disability. There was no differential effect of anxiety by sex found in this study. Conclusions Post-stroke anxiety has an adverse effect on disability at one year among young stroke survivors.